St. Clair Hospital HouseCall Newsletter_Vol IV Issue 3

Volume IV Issue 2 I HouseCall I 2

VOLUME IV ISSUE 3

inside The Fine Art Of Plastic Surgery I Educating Patients Living With Diabetes I Ask The DoctorSt. Clair Hospital Ranked Among 100 Top Hospitals In The Nation I Physical Therapy Expansion

HouseCall

Visionarycare

2 I HouseCall I Volume IV Issue 3

Patient Profile

Providing Better Vision for a

Better Qualityof Life


As a retired optometrist, Dr. Robert Nungesser knowseyes better than most people.He also understands theunique visual challenges

people living with cataracts face on a daily basis.Not only did he often treat patients who sufferedfrom cataracts, but he also developed them himselfas he got older. As a result, he began to experiencedecreased vision, which made it especially moretroublesome for him to drive at night when hewould see “halos” around approaching headlights.

The 81-year-old Scott Township residentknew where to turn for help. For years, he hadreferred cataract patients for surgery to JamesP. Mondzelewski, M.D., founder of Glaucoma-Cataract Consultants, located near the maincampus of St. Clair Hospital.

Dr. Mondzelewski determined thatDr. Nungesser was an excellent candidate forthe Crystalens, an FDA-approved intraocular(IOL) lens, that Dr. Mondzelewski offers hispatients. IOLs are always used in cataractsurgery because they replace the eyes’naturallenses, which are removed during surgery.However, the Crystalens offers better vision at multiple distances than other IOLs because it is able to shift position with the action of eye muscles as a person focuses.

According to Dr. Mondzelewski, the Crystalensis designed with hinges on each side. These allowthe optic, which is the central portion of the lensused for viewing, to flex back and forth as a patientchanges focus on imagesin his or her line of sight.

“The Crystalens givessome cataract patients a better ability to focus,”he says.“It also allowspatients to be free ofglasses the majority of the time.”

Dr. Nungesser hadhis surgery in Februaryof this year at the Mt.Lebanon Surgical Centerin the St. Clair Hospital Professional OfficeBuilding. Today, his distance vision is sharperand he can now drive at night with no problems.

“This was a very uncomplicated procedure,so I was not apprehensive about it,” he says.“Also, if Dr. Mondzelewski is performing yoursurgery, you’re in great hands.”

Unlike Dr. Nungesser, 34-year-old MatthewJobson is not an optometrist. However, sincethird grade, he was used to seeing one every yearbecause of his poor eyesight. The St. Clairsville,Ohio resident, who works as a pharmacist in a hospital in Wheeling, had -12 diopters ofnearsightedness vision in each of his eyes —

meaning that, withoutglasses, he could barelysee objects right in frontof him. He didn’t likewearing glasses muchand contact lenses onlydried his eyes out afterextended wear.

While most near-sighted patients wouldelect for LASIK surgery to improve their vision,Jobson was not a good

candidate because of his extreme nearsighted-ness. During a LASIK consultation with anothersurgeon, he learned about a relatively new vision correction solution called the ImplantableCollamer Lens (ICL), also known as the “Implantable Contact Lens.” Dr. Mondzelewski is one of the few eye surgeons in the region

performing this procedure. Through research,Jobson discovered Dr. Mondzelewski and wasdelighted to learn that he was located arelatively short drive away from his homein Ohio.

The ICL is a refractive lens that can correctvision up to -15 diopters of nearsightedness,making Jobson a near-perfect candidate.During surgery, this lens is implanted behindthe iris and in front of the natural crystallinelens. Dr. Mondzelewski stresses that unlikeLASIK eye surgery, the ICL procedure does notpermanently alter the shape of the cornea —and it is also a fully reversible procedure. Infact, he says that it is more similar to cataractsurgery. The surgery itself is performed on an outpatient basis, and only takes about 15 minutes per eye.

As in cataract surgery, patients undergoingan ICL procedure have one eye done at a time,with about two weeks between procedures.Recovery time is only about two days per eye.

“The ICL procedure also provides clearerimaging than LASIK,” Dr. Mondzelewski says.“A small, 2.5-millimeter incision is made in theeye, along with two other smaller one-millimeterincisions. The lens is then folded and implanted

refining focus

Continued on page 5

IOL surgery patient Dr. Robert Nungesser, a retired optometrist from Scott Township.

At left: Eye Surgeon James P. Mondzelewski, M.D. peers through a surgical microscope in an operating room at St. Clair Hospital’s Mt. Lebanon Surgical Center.

Cover: St. Clair Hospital Surgical Technician Kelly Trevelline, right, assists Dr. Mondzelewski during a recent cataract surgery at the Center.

“This was a very

uncomplicaTed procedure,

so i was noT apprehensive

abouT iT. also, if

dr. mondzelewski is

performing your surgery,

you’re in greaT hands.

”EYE SURGERY PATIENT DR. ROBERT NUNGESSER


Unlike LASIK eye surgery,the ICL procedure does notpermanently alter the shapeof the cornea — and it isalso a fully reversibleprocedure. It is moresimilar to cataract surgery.The surgery itself isperformed on an outpatientbasis, and only takes about15 minutes per eye.

“iT’s been simply amazing To noT

have To worry abouT wearing

glasses or conTacT lenses.

i highly recommend The icl

procedure. iT’s very safe and

i’m very happy wiTh my resulTs.

”ICL SURGERY PATIENT MATTHEW JOBSON

Dr. Mondzelewski performs eye surgery at the Mt. Lebanon Surgical Center at St. Clair Hospital.

in the eye, and then unfolded and placed inthe proper position in the eye. The incisionsare self-sealing, so no stitches are necessary.”

While the surgery is performed with relativeease, the preparation for surgery is critical,says Dr. Mondzelewski. The lens has to becarefully sized and custom-fitted for each eye.This pre-operation is typically done atGlaucoma-Cataract Consultants about twoweeks prior to surgery. It usually takes aboutthree visits to properly size a new implantable lens.

Jobson admits having been a little nervousprior to his eye surgery back in September,but he was also confident that he would befine under Dr. Mondzelewski’s care.

“He was experienced in doing thisprocedure and he was also very easy to talkto,” he says. “He inspired confidence in methat I would receive good treatment underhis care.”

Today, Jobson is enjoying 20-20 visionand, for the first time in his life, he doesn’tneed corrective lenses.

“It’s been simply amazing to not have toworry about wearing glasses or contactlenses,” he says. “If you want to do somethingthat will improve your quality of life and yourvision, then I highly recommend the ICLprocedure. It’s very safe and I’m very happywith my results.”

In addition to the Crystalens and ICLprocedures, Glaucoma-Cataract Consultants

also specializes in glaucoma and suture-less,patch-less cataract surgery.

“It’s been an intimate relationshipbetween our practice and St. Clair Hospital,”says Dr. Mondzelewski. “We find it veryadvantageous to be located near the hospitalcampus. We have provided quality surgicaleye care utilizing their very excellentoperating rooms and outpatientsurgical centers.” n

Patient ProfileContinued from page 3


ICL surgery patient Matthew Jobson on the job in the Pharmacy Department at a Wheeling, W. Va. hospital.

JAMES P. MONDZELEWSKI, M.D.

Dr. Mondzelewski specializes in ophthalmology. He earned his medicaldegree at The Ohio State University School of Medicine and completedhis residency in ophthalmology and a fellowship at Eye and EarHospital, Pittsburgh. Dr. Mondzelewski is board-certified by the AmericanBoard of Ophthalmology. He practices with Glaucoma-CataractConsultants, Inc.

To contact Dr. Mondzelewski, please call 412.572.6121.


Patient Profile

the fine art ofPlastic surgery

Plastic surgery patient Rebecca Fuscardo touches up a 5‘ x 15‘ mural of The Last Supper that she paintedon the dining room wall of a client in Steubenville, Ohio.


P icture the hands of an accomplished artist. Now consider the creative process, the focus and passion that the artist brings to her work and expresses through her hands— hands throughwhich a vision becomes substance, beauty is

awakened, and the spirit within is expressed.Simona V. Pautler, M.D. brings such an artistic spirit to her

work as one of the Pittsburgh region’s pre-eminent reconstructiveand cosmetic plastic surgeons. She is an artist, literally and figuratively, and she uses the tools and technology of state-of-the-art plastic surgery at St. Clair Hospital to shape, restore,renew, and transform bodies and faces. Since her childhood, Dr. Pautler has been drawing and sculpting, exploring and expressing a natural artistic talent that has taken her, happily,from the studio to the surgical suite. “I never needed to take an art class when I was growing up,” she says. “I was able to draw or sculpt anything. In medical school, I realized that I could transfer my artistic talent to plastic surgery. I think of plastic surgery as an elevated art form. It changes the quality of people’slives. Being a plastic surgeon enables me to express myselfthrough my hands.”

Dr. Pautler, whose primary office is in McMurray, performsa variety of surgical procedures at nearby St. Clair Hospital. She emphasizes natural results and specializes in tummy tucks,breast augmentation or reduction, face lifts, liposuction, brow lifts,and eye and nose plastic surgery. She also offers a range of skincare treatments and services. “The goal is always improvement, not perfection,” Dr. Pautler notes.

Once the domain of celebrities, plastic surgery is increasinglysought by “ordinary” people who want to improve their appearance,correct flaws, and feel better about themselves. The perception of plastic surgery among the public is changing, Dr. Pautler acknowledges. She credits reality TV shows such as “ExtremeMakeover” to opening the eyes of the American public to the possibilities of plastic surgery and to making it more acceptable.“People are less secretive about having plastic surgery; they’re no longer embarrassed to talk about it.”

Her patients come from all corners of the region. “My patientsare not from affluent neighborhoods; they are regular people andthe majority are women. Many are working mothers. Plastic surgeryis not just for the rich and famous; it’s for anyone who wants it.”

“i never needed To Take

an arT class when i was

growing up. i was able To

draw or sculpT anyThing.

in medical school, i realized

ThaT i could Transfer my

arTisTic TalenT To plasTic

surgery. i Think of plasTic

surgery as an elevaTed

arT form. iT changes The

qualiTy of people’s lives.

”PLASTIC SURGEON SIMONA V. PAUTLER, M.D.

the truck Driver

It’s 8 a.m. on a weekday in Downtown Pittsburgh and Diann Taylor is on the job, driving a pickup truck to deliver heavy equipment, tools,and propane tanks to major construction sites around the city.

The Bethel Park native has been driving a truck for Century SteelErectors for more than 20 years, helping to build the region’s bridges and buildings. She loves the job. The only downside to it is the long periods of sitting, but Taylor compensates by leading an active lifestyleand exercising vigorously on a regular basis. Regularly joined by herboyfriend, Scott, she enjoys taking her three dogs for daily walks on the trails near her Burgettstown home.

It’s a happy life, and the 49-year-old mother of one son was satisfied—with one exception. “I was uncomfortable with my flabby, muffin-topbelly,” she reveals. “I’m not overweight and I work out a lot, but I lookedawful in a bathing suit. My belly didn’t fit the rest of me ― the way I live or who I am.

Forty-nine-year-old Diann Taylor says that

since her surgery, she feels likeher body fits who she is— a

woman who is active on the job, and off.

Continued on page 8

I tried laser and other treatments, but they didn’t work because I had scar tissue from a C-section. I decided to try liposuction and my sister told me about an excellent plastic surgeon—Dr. SimonaPautler.”

Taylor made an appointment for a liposuction consultation with Dr. Pautler, but learned that it would not solve her problem. “Dr. Pautler gently explained to me that I needed a tummy tuck, because liposuction would not get rid of my excess skin. I loved herhonesty and the fact that she spent time with me, explaining things. I told her to schedule the surgery, and she told me to bring my favoritebikini bottom to the hospital, so she could determine where to makethe incision.”

Taylor underwent the procedure, formally known as abdomino-plasty, in late November at St. Clair Hospital, and she is thrilled withthe results. “My stomach is flat, with a beautiful contour. I dropped

down two sizes and lost four inches at my waistline. This isn’t weightloss surgery, but I look like I’ve lost weight. I haven’t looked this goodsince I was a teenager.”

Abdominoplasty gives the abdomen a more youthful shape, withflatter, tauter skin and a firmer look to the navel. Most often, patientswho undergo a tummy tuck have loose skin, stretch marks, and abdominal bulging in the lower abdomen, secondary to weight fluctuation or pregnancy. Exercise and diet have no effect on tighteningthe loose, saggy skin. The incision is placed lower than a C-sectionscar, from hipbone to hipbone. Most bikini bottoms will cover the scar.“In plastic surgery, there are no shortcuts; you can’t get anything donewithout a scar,” Dr. Pautler explains, “although we try to place scarsin concealed places. It takes a few months to see the final result.”

A tummy tuck can be combined with liposuction from the waistand “muffin-top” region and is sometimes performed along with a



“i didn’T expecT The changes on

The inside. i feel beTTer abouT

myself; i’m more confidenT.

”PLASTIC SURGERY PATIENT DIANN TAYLOR

Diann Taylor at a job site in Oakland for Century Steel Erectors.

tubal ligation, hernia repair, or hysterectomy. Breast surgery to enhance or reduce the breasts can be done at the same time to give the entire torso a renewed appearance and tone.

A tummy tuck procedure is major surgery, done under generalanesthesia, and an overnight admission is recommended, althoughnot essential. The post-operative course can be challenging for thefirst week or two, until the swelling subsides and drains are removed.“It wasn’t a walk in the park,” recalls Taylor, “but it was absolutelyworth it. I slept in a recliner at first, and walked in a hunched-over position, but I was back to doing office work in two weeks. Thanks tothe quality of Dr. Pautler’s work, my scar is already gone; there is noevidence of what I had done, and as long as I don’t gain weight, mybelly will remain flat. I can tie my shoes and shave my legs again!”

Her enthusiasm extends to St. Clair Hospital and especially to the nursing staff who cared for her. “The nurses gave me excellentcare; the Hospital is great and even the food was good. I had my surgery during Thanksgiving week and Dr. Pautler called me on Thanksgiving Day to ask how I was doing. That’s how caring she is.”

Most surprising to Taylor is the psychological impact of the procedure. “I didn’t expect the changes on the inside,” she says. “I feel better about myself; I’m more confident. I know I look good in my clothes.”

the artist

Rebecca Fuscardo is a patient of Dr. Pautler with a different story. She is a 45-year-old professional artist, a wife, and a mother of three who lives in Weirton, W. Va. She is a powerhouse of a woman, constantly engaged in multiple art projects that showcase her versatile talent. Known primarily for painting murals in churches,schools, homes, and businesses, Fuscardo also does artistic paintingon cars and motorcycles, and more recently began doing decorativeconcrete work, carving and painting it for outdoor kitchens and patios.Fuscardo radiates so much energy, joy, and optimism that it’s hard to imagine that, not so long ago, she was profoundly depressed.

In her home state, Fuscardo had experienced a botched abdominalhysterectomy that left her mutilated and in pain. With severe abdominalscarring and a crooked, displaced navel, she found it difficult to workand manage her life. Her scars were so thick and protrusive that theyshowed through her shirts and caused pain when anything, even fabric, came into contact with them. Her physically demanding workoften entails climbing on ladders and getting on her hands and knees, and the condition of her abdomen made this uncomfortable. “It seemed impossible to me that this could ever be fixed. I saw several doctors who had nothing to offer me. I was resigned to livingwith the scars and the pain for the rest of my life. I became depressed;I cried and felt self-conscious. My belly was disgusting, all scarredand puckered. I had to wear big loose clothes. My kids said my bellylooked like Mr. Yuk.” Fortunately, she saw a new gynecologist, who referred her to Dr. Pautler. “I was thrilled when I met Dr. Pautler,”says Fuscardo. “She spent an hour with me in my consultation and

was so concerned for me. I loved everything about her; she’s warmand caring and even her office has an aura of happiness and positivity.Most importantly, Dr. Pautler gave me hope.”

Dr. Pautler gave Rebecca Fuscardo more than hope ― she gaveher a new torso and a transformed body image. She performed atummy tuck and included liposuction in order to get additional skin to pull and tighten. The procedure totally reshaped Rebecca’s torso,giving her a beautiful flat tummy and a “new” navel ― in the rightplace. “I look like I’ve had a breast lift, too, because pulling the muscles and skin tightly together elevated my breasts. The surgeryfar exceeded my expectations ― I can actually wear a two-piecebathing suit.”

Fuscardo says she feels reborn. “Now, I am ready for anything. I would do it again tomorrow. Dr. Pautler transformed me ―my bodyand my life. I am back to being my old self, but even better, and I feellike nothing can stop me. A friend said, ‘Your personality is back andeveryone wants to be around you now.’ My primary care doctor toldme she has never seen me look better or healthier.”


“The surgery far exceeded

my expecTaTions. i can acTually

wear a Two-piece baThing suiT.

now, i am ready for anyThing.

i would do iT again Tomorrow.

”PLASTIC SURGERY PATIENTREBECCA FUSCARDO

Continued on page 10

SIMONA V. PAUTLER, M.D.

Dr. Pautler specializes in plastic surgery. She earned her medicaldegree at Columbia University in New York City and completed herprofessional training at Columbia Presbyterian Medical Center, YaleNew Haven Hospital in Connecticut, and Dartmouth Hitchcock MedicalCenter in New Hampshire. She is board-certified by the AmericanBoard of Plastic Surgery. Her primary office is in McMurray.

To contact Dr. Pautler, please call 724.969.0930.



“Plastic surgery completely changed her. It was remarkable,”Dr. Pautler says. However, such dramatic change is not the norm, shecautions. “You have to have realistic expectations for plastic surgery. Some people want perfection and expect their whole lives to change. I can’t deliver that. Most people are happy with improvement.”

For women ― and men ― who are considering a tummy tuck, Dr. Pautler has some sage advice. “The best patients are those whohave sound expectations, are in good overall health, and have a stablesupport system. Non-smokers are the best candidates; smokers havean impaired ability to clear infections and heal; their wounds tend to be weak and to separate more easily.

“A tummy tuck gives you improved core strength, and that’simportant. You need a strong abdomen for everything you do. The procedure is safe; complications are rare, but potential ones includebleeding, infection, delayed wound healing, and prolonged swelling.Very rarely, a blood clot might develop in the leg as a result of decreased mobility, but I get my patients out of bed quickly to preventthat. I tell them, ‘Take a few weeks to lie low, but don’t become bedridden.’ Some patients choose to go home right after surgery, but I prefer that they stay for one night at St. Clair so we can managetheir progress. They’re well cared for; the nurses are there to attend to them and monitor them. I think it’s hard on family members whenthe patient goes right home after surgery.

“Cosmetic surgery is not reimbursed by third party payors, but reconstructive surgery is. If you need cosmetic surgery due to complications from an accident or cancer, it may be covered.”

Dr. Pautler finds great satisfaction in seeing her patients at theirpost-operative office visits. “That’s the best moment, when they comein and I see how happy they are and how good they look. That seals the deal. I have moments when I think, ‘I could be home with my kidsinstead of doing this,’ but when I realize how much this means to thepatients, I know I’m doing something good. For me, being a plastic surgeon is both artistic and gratifying.”n

“i have momenTs when i Think,

‘ i could be home wiTh my kids

insTead of doing This,’ buT when

i realize how much This means

To The paTienTs, i know i’m doing

someThing good.

”SIMONA V. PAUTLER, M.D.

THE DIABETES CENTER:

Educating PatientsLiving with Diabetes

When Kris Kessler went in for her annual physicalexam last November, the Bethel Park residentwas surprised to discover that her blood sugarlevels were slightly elevated. Her primary carephysician, M. Sabina Daroski, M.D. of

Fatigati/Nalin Associates, was concerned that she could developtype 2 diabetes, and asked her to come back in three months forfurther tests.

Ke ssler, who is 54 years old and works as an administrativeassistant and controller for a local construction company, did notexperience any symptoms to indicate she had diabetes. However,because of her family history, she knew that she was at higher riskfor developing it.

As a result, Kessler returned in late January for more bloodwork and received her results in early February. Her hemoglobinA1c test—which is an important blood test that reflects blood sugarlevels over the past 2 to 3 months—was at 6.3 percent. Dr. Daroskiwanted to see it at 6.0 percent. Kessler’s blood sugar level was at126; Dr. Daroski wanted to see it under 120.

“Diabetes is a common and complex condition. We really aska lot of patients in terms of taking control of their medical life,because it is something that no single professional, no matter howaccomplished, can manage independently,” says Dr. Daroski. “Simplyput, no doctor can do anything significant to treat a patient’sdiabetes without the full support of the patient. A pill simply won’tdo the trick. Proper exercise, eating habits, and other factors thatonly the patient controls are as, or more, important than any‘medical’ intervention.”

Due to her age and hereditary factors, Kessler was placed on awatch list for type 2 diabetes, meaning she had to get on the righttrack with her diet and begin to exercise more.

“I had a choice to get started on medication to control my bloodsugar,” says Kessler. “But my physician said I could get my bloodsugar levels down with proper eating and exercise, so I chosethat route.”

Dr. Daroski referred Kessler to the St. Clair Hospital DiabetesCenter, which is located at the Hospital’s Outpatient Center at Village Square in Bethel Park. At the center, patients with diabetes,or who are at risk for diabetes, meet with Certified Diabetes Educatorsand Registered Dietitians, who help them learn about diabetes, and work with them to develop strategies for managing it.

For Dr. Daroski, the Diabetes Center is crucial in teachingpatients just diagnosed with diabetes the basics of their conditionand its management.

“My experience with the Diabetes Center has been universallypositive. Patients enjoy the classes and one-on-one instruction,”says Dr. Daroski. “They come away from the center rechargedand empowered.”

She adds that patients who are ‘old pros’ about their diabeteslearn new and more detailed information about the condition, andget useful tips and reminders about management. The program isrecognized by the American Diabetes Association for meeting theNational Standards for Diabetes Self-Management Education. Any physician managing a patient with diabetes can refer them tothe education program, which has been in operation since 2003.They see about 700 patients each year.

Kris Kessler of Bethel Parkwalks near her home every dayas part of an exercise plan toward off type 2 diabetes.


healthY choices

Continued on page 12

“Our approach is very individualized,”says Beth Ann Coonrod, Ph.D., a CertifiedDiabetes Educator and the coordinator ofthe diabetes education program.“We meetwith patients on a one-on-one basis and ingroup classes. Over several visits, we helpthem develop management plans that fitwith their lifestyles.”

Coonrod views the program’s role as apartnership with the primary care physician.“Besides teaching, we can provide a lot ofassistance with their patients’ blood sugarmanagement — not just because of our clinicalexpertise, but also because of the time we canspend assessing patients’ circumstances and

strategizing with them.”She adds, “Understanding patients’

lifestyles, schedules, and personal goalsis a critical part of that assessment andan essential component of helpingpatients develop action plans that theybelieve are doable. That takes time.” An appointment with a Certified Diabetes

Educator or a Registered Dietitian typicallylasts between 1 to 11⁄2 hours, a luxury notafforded to physicians.

BRIDGET K. BEIER, D.O.

Dr. Beier specializes inendocrinology. She earnedher medical degree at LakeErie College of OsteopathicMedicine and completed herinternship and residency at theUniversity of Connecticut HealthCenter and a fellowship at

Virginia Commonwealth University Health System.Dr. Beier is board-certified by the American Boardof Internal Medicine. She practices with Associatesin Endocrinology, P.C.

To contact Dr. Beier, please call 412.942.2140.

CAMILLE M. BUONOCORE, M.D.

Dr. Buonocore specializes inendocrinology. She earned hermedical degree at StateUniversity of New York atBuffalo and completed herinternship, residency and afellowship at the Universityof Pittsburgh Medical Center.

Dr. Buonocore is board-certified by the AmericanBoard of Internal Medicine. She practices withAssociates in Endocrinology, P.C.

To contact Dr. Buonocore, please call 412.942.2140.

ST. CLAIR HOSPITAL’S DIABETES CENTER OFFERS COMPREHENSIVE CARE

Kris Kessler enjoysa healthful lunch..

Statistically speaking, diabetes is on the rise, not only in the U.S., but acrossSouthwestern Pennsylvania.

People with diabetes need the expertise of not only their primary care physicians, butendocrinologists, dietitians, and nurse educators to help them manage their conditionsand better understand how diabetes impacts their lives.

St. Clair Hospital’s Diabetes Center provides all of this expertise in one, convenientlocation ― St. Clair Hospital’s Outpatient Center at Village Square in Bethel Park.

As part of the center’s Empowerment Program, staff works with pre-diabetic anddiabetic patients, along with their primary care physicians, to provide the comprehensiveeducation and support they need to stay healthy and reduce the risk of complications.

The center’s highly trained, compassionate staff meets with patients individually to develop personalized plans to manage their respective medical needs.

This customized plan includes:• Blood Glucose Monitoring • Insulin Administration• Diabetes Medications • Exercise Strategies• Meal Planning • Sick-Day Management

The staff of the St. Clair Hospital Diabetes Center includes Medical Director CamilleBuonocore, M.D., endocrinologist Bridget Beier, D.O., as well as a team of nurseeducators and dietitians who work with patients each day.

For more information, please call 412.942.2151.

Of course, there is so much for a patient tolearn about diabetes, more than anyone canabsorb in one sit-down appointment. So, theDiabetes Center also offers group classes splitbetween two sessions. Coonrod notes that theseclasses are instructional and educational, and nota “sit-in-a-circle-and-share” type of class.

Kessler found both the individual appointmentsand the group classes extremely beneficial.During her meetings with the educators anddietitian, Kessler learned more about diabetes,what it does to your body, why you get it,and the recommended diet to help youcombat it.

“The sessions were enormously helpful andthey were wonderful, well-educated people,” shesays. “They did a wonderful job and explainedeverything in layman’s terms.”

Specifically, they discussed Kessler’s lifestyleand eating habits. One reason why Kessler’sblood sugar levels were high was because she ate too many carbohydrates at meals.

“I learned that there are two main thingsyou need to look at when you’re trying to controlyour blood sugar: carb intake and serving size,”says Kessler.

healthY choicesContinued from page 11



The recommended diabetes meal planshould be naturally rich in nutrients andlow in fat and calories. Kessler was delightedto learn that she could still eat her favoritefoods, but in moderation. Additionally, shecould snack during the day, before lunchand dinner, and before going to bed. Inaddition to eating better, Kessler has beenwalking 30 minutes every day, either outsideor on a treadmill if the weather is bad.

By following this plan, Kessler has beenable to lose weight and keep her blood sugar level down. More importantly, it hasn’t beena struggle to follow her new eating andexercise plan, because the clinicians at theDiabetes Center worked with her to comeup with a plan that takes her personalpreferences into account.

“You can find foods that you like to eatand just need to count carbs,” she says.“When you count carbs, you can’t believehow much your portion sizes shrink.”

Kessler also found the group classes,taught by Coonrod, extremely helpful.“Knowledge is a powerful thing,” says Kessler.

Coonrod says that patients need to meetone-on-one with an educator before attendingthe group education sessions, so that theirindividual needs are sure to be addressed.

“Some content applies to everyone, but other information needs to be highlytailored to the individual,” she says. “Sometimes people are hesitant to meetwith someone to focus on their diabetesmanagement. For example, they might beconcerned about seeing a dietitian becausethey think they will be told that they shouldnot eat certain foods that they enjoy. LikeKris, when meeting with the dietitian theydiscover they can still enjoy eating foodsthey like. I often see patients walking outof their appointments very happy, becausethey learned that they have a lot moreoptions than they had thought. Our centeris a tremendous resource for people totake advantage of.”

Another reason people may shy awayfrom getting help with their diabetes management is because they believe thatthey will be judged on their blood sugar

readings. That belief can come from theirthinking that they must be doing somethingwrong. Unfortunately, that belief often stemsfrom the fact that they have been judged.That will never happen at the St. Clair Hospital Diabetes Center.

“When people meet with us, they oftendiscover that they weren’t doing somethingwrong,” says Coonrod. “Many are surprisedto learn that high blood sugar levels aren’talways due to how they are eating.”

Kessler strongly urges other patientswho are at risk for developing diabetes, or those who may be living with diabetes,to go through this education process.

“If you’re diabetic and you have no clue how to sustain yourself and controlthis disease, then you’re just putting one bad foot in front of the other,” she says. “You need to understand what’s wrongwith you and how you can fix it. The onlyway to do that is through education. If youunderstand what’s wrong with you, you can take steps to fix it.”

Dr. Daroski agrees. “Educate yourself!”she says. “Look online at the ADA website,diabetes.org, and at the National Institutes of Health site at diabetes.niddk.nih.gov. Talk to your health care professional atlength. Talk to diabetes educators. Look atcures advertised on TV with a healthy dose

of skepticism. Above all, remember thatyou have a life to live and that managingyour diabetes, rather than ignoring it, is the best way to enjoy that life.”

Coonrod adds that the earlier people get involved in managing their diabetes, themore advantage they have in controlling it.

“What Kris did was great,” she says.“She was proactive and just took the bull bythe horns and came in to learn what couldbe helpful for her diabetes management.”

Coonrod is quick to note, however, thatit is never too late to get involved or torenew involvement. “Naturally, there canbe a lot of ‘falling off the horse.’ We canhelp people with getting back on.”

She adds that yearly follow-upappointments can be very beneficial. Inaddition to diabetes education, the DiabetesCenter has a Wellness Group that meetsevery other month to discuss topics such as stress management, eye care, foot care, and conditions that are more common inindividuals who have diabetes, for example,sleep apnea. These sessions are free andopen to the public.n

For more information about the Diabetes

Center and the services it provides, please call 412.942.2151.

M. SABINA DAROSKI, M.D., FACP

Dr. Daroski, who is Chair of the Department of Medicine at St. Clair Hospital,specializes in internal and geriatric medicine. She earned her medical degreeat Northeastern Ohio College of Medicine and completed her residency ininternal medicine at Mercy Hospital of Pittsburgh. Dr. Daroski isboard-certified by the American Board of Internal Medicine. She practiceswith Fatigati/Nalin Associates and is based out of the Mt. Lebanon office.

To contact Dr. Daroski, please call 412.343.1770.

“remember ThaT

you have a life To live

and ThaT managing

your diabeTes,

raTher Than ignoring

iT, is The besT way

To enjoy ThaT life.

”M. SABINA DAROSKI, M.D.

Diet and exercise can reduceby 57% the risk of progressingfrom pre-diabetes to diabetes.

MATTHEW G. PESACRETA, M.D.

Dr. Pesacreta specializes in nephrology. He earned his medical degree at the University of Pittsburgh School of Medicine and completed his residency and fellowships in nephrologyand geriatrics at the University of Pittsburgh Medical Center. Dr. Pesacreta is board-certifiedin nephrology and geriatrics by the American Board of Internal Medicine. He practices withTeredesai, McCann & Associates, P.C.

To contact Dr. Pesacreta, please call 412.572.6129.

ask the Doctor

MATTHEW G. PESACRETA, M.D.

Ask the Doctor

Q

ACKD is a condition in which the kidneys are damaged,

for any number of reasons, and can no longer function

properly. CKD is detected through a blood test to

estimate the kidney function, and/or a urine test to

assess for the presence of protein in the urine. Most

people do not have any symptoms at the time of

diagnosis and are surprised to learn they have CKD.

In the United States, more than 20 million people

have CKD, with more women than men affected.

CKD is staged from 1 (mildest form) to 5 (most

severe) based on degree of kidney damage. The two

main causes are diabetes and hypertension

(high blood pressure), but there are

several other causes. Other conditions

might play a role in the progression

of CKD, namely obesity and high

cholesterol. The risk of CKD also

increases with age, as we all lose

approximately 1 percent of kidney

function every year after age 40.

When patients first hear of CKD, their

first concern often is kidney dialysis.

There are approximately 300,000

people on dialysis in the United

States, but many people

with CKD do not progress

to end stage renal

disease (ESRD). With

that said, patients with

CKD have a higher risk of cardiovascular disease,

such as heart attacks, heart failure and stroke, and

death at an earlier age, as compared to populations

without CKD. Fluid and electrolyte balance, waste

removal, acid-base balance, bone health, and the

regulation of anemia are a few of the important roles

the kidneys play in maintaining our overall health.

As CKD progresses, these issues often need close

attention to maintain optimal health.

A common question asked is, “What can I take or

do to ‘improve’ my kidney function?” Unfortunately,

CKD is often irreversible and progressive over time,

but there are several ways to slow the progression.

Prevention and treatment of the risk factors for CKD

is paramount to therapy. This often starts with a visit

to a primary care physician to assess for the presence

of CKD. For patients with high blood pressure,

maintaining a blood pressure less than 130/80 is

optimal. This will often include a low sodium diet,

in addition to prescribed medications. Diabetics

should try to keep their A1C (glucose) less than

7 percent, and an overall healthful lifestyle is strongly

encouraged. This includes exercising several days

a week and not smoking.

Depending on the severity of CKD, your primary

care physician may refer you to a nephrologist,

a physician with specialized training in medical

kidney disease. n

I have been diagnosed with chronic kidney disease (CKD).

What exactly does that mean and what do I need to do?



continueD growth

new outPatient Pt DePartment at village square

S T R E T C H E S i t s c a P a B i l i t i e s

fast facts on the new outPatient PhYsical theraPY DePartment

at st. clair hosPital outPatient center at village square

St. Clair Hospital’s Outpatient PhysicalTherapy Department has long beenrecognized for its highly skilled team

of licensed physical therapists, therapistassistants and support staff who collaborateto provide compassionate, personalized carefor a wide-range of needs. Now, due tocontinued growth, the center has openeda newly renovated and greatly expandedspace at the Hospital’s Outpatient Centerat Village Square.

Physical Therapists began treatingpatients in the new, patient-friendly spacein May, according to Director of OrthopedicsBob Kovatch, MPT, MBA. “Our goalremains the same: returning patientsto their previous level of functioning bydecreasing pain, and restoring loss of motionand strength,” Kovatch says. “Now thefacility better matches the quality of care.The openness of the new therapy clinic has greatly enhanced patient flow and has created an atmosphere pleasing forpatients and employees alike. Having theadditional room has allowed us to add newequipment, enabling us to offer enhancedtreatment options for patients. Also, we’veincreased the number of individual examrooms and added several curtained areas,providing increased patient privacy.”

Bob adds: “We’re very happy to nowhave a dedicated suite for therapy services,while still being in close proximity to othersupporting services, such as Laboratory,Imaging, and Occupational Medicine, all of which are in the same building andprovide ‘one-stop’ health care services forour patients.” n

• Patients are treated by qualified licensedPhysical Therapists (PT) and Physical TherapistAssistants (PTA), with support provided by a PT aide.

• The combined years of experience amongcurrent Outpatient PT/PTA staff is 75 years.

• PTs use a variety of treatment techniques,such as exercise; gait (walking) training;balance activities; heat/cold modalities;electrical stimulation; traction; and tissuemobilization/manual therapy techniques.

• Each patient is given a thorough evaluationby a PT, who then sets up a treatmentprogram based on the particular needsof the individual.

• Patient education is a key component ofOutpatient PT and is incorporated in patients’treatment programs. Patients are givenexplanations of their particular diagnoses,as well as the treatment modalities andexpected results. Much emphasis is spenteducating patients on their individualizedhome exercise program, as well as preventativemeasures for future issues.

• The PTs treat a multitude of diagnoses in patients, including youth/young adults with sports related injuries.

• The Outpatient PT Department works closelywith the Occupational Medicine Departmenton work-related injuries, pre-employmentscreenings, and work capacity evaluations.

• Specialty areas of the Outpatient PTDepartment include Vestibular Rehaband Pilates program.

• Hours of operation of the Outpatient PTDepartment are 7:30 a.m. to 7:30 p.m.Mondays through Thursdays; 7:30 a.m.to 5 p.m. Fridays.

• The Hospital offers a free Courtesy Vanservice for patients who are having difficultyarranging transportation to Outpatient PT.

• Services are by appointment only. A validprescription from a physician is required to make an appointment. Most insurancesare accepted.

To contact Outpatient PT, please call 412.942.7122.

General & Patient Information Physician Referral Service Outpatient Center – Village Square Medical Imaging Scheduling 412.942.4000 412.942.6560 412.942.7100 412.942.8150

St.Clair Hospital1000 Bower Hill RoadPittsburgh, PA 15243www.stclair.org

is a publication of St. Clair Hospital. Articles are for informational purposes and arenot intended to serve as medical advice. Please consult your personal physician.

Follow us on twitter at: www.twitter.com/stclairhospitalHouseCall

Thomson Reuters has named St. Clair Hospital one of the nation’s 100 Top Hospitals.

The prestigious award was based on an analysis of St. Clair’spatient safety, clinical outcomes, patient satisfaction and clinicalefficiency, all key indicators of performance excellence.

Since 1993, Thomson Reuters has used independent objectiveresearch to identify the nation’s 100 Top Hospitals. Hospitals do notapply or pay for this honor, or pay to promote their award. Only ahandful of hospitals, such as Mayo Clinic, Beth Israel Deaconess(a Harvard Medical School teaching affiliate), Northwestern UniversityHospital and Vanderbilt University Medical Center, have beenperennial winners of the award.

Thomson Reuters estimates that if all U.S. hospitals performedat the level of the 100 Top Hospitals:

• More than 186,000 lives could be saved;• Approximately 56,000 additional patients would becomplication-free; and

• More than $4.3 billion could be saved.St. Clair salutes its talented and caring physicians, employees

and volunteers for delivering this superior care throughstate-of-the-art technologies and advanced processes.

RANKEDAMONG THE 100 TOP OSPITALSIN THE NATION.

St. Clair Hospital HouseCall Newsletter_Vol IV Issue 3

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